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How Can Nigeria Attain Universal Health Coverage in 2030?

by Isiyaku Ahmed

Isiyaku Ahmed

The global community celebrated Universal Health Coverage (UHC) on the 12th December. Nigeria, having signed a treaty to attain UHC coverage by 2030 has developed various policies to ensure no one is left behind in accessing essential health services.

The Federal Government of Nigeria introduced the Basic Healthcare Provision Fund (BHCPF), a basket pool of funds from Federal Government, donors and other sources that is aimed at strengthening service delivery, emergency care and to remove financial barriers when fully implemented.

Recently, the Nigerian parliament approved a law that makes having a health insurance coverage mandatory for all residents in Nigeria.

Also, the National Health Insurance Scheme (NHIS) had decentralized the implementation, so that all 36 states can set up State Social Health Insurance Schemes, having realized that a unitary scheme was only able to achieve less than 10% coverage after more than a decade of implementation.

States like Kaduna, Lagos, Kano, Plateau, Yobe, Oyo, Delta, etc. already have their health insurance schemes are up and running.

Jigawa state Government led by His Excellency Abubakar Badaru, recently launched the Jigawa Contributory Health Management Scheme on the 30th November 2020.

At the launch, the Executive Secretary of Jigawa Contributory Health Scheme acknowledged the efforts of the Women Integrated Sexual Health (WISH), PERL, LAFIYA program and other development partners in supporting the design and implementation of the Scheme.

Governor Badaru also said the vision of his government is to ensure that everyone in Jigawa state has “access to comprehensive, appropriate, affordable, efficient, equitable, and quality essential healthcare.”

Going by the Governor’s statement, the focus of government has shifted to social transformation agenda of which universal access to quality healthcare is critical.

The Partnership to Engage, Reform and Learn (PERL) is a UKAid Foreign and Commonwealth Office (FCO) program that supports governments to organize their core business of making, implementing, tracking and accounting for policies, while LAFIYA Program is focused on improving the health outcomes for the poorest and most vulnerable in Borno, Jigawa, Kaduna, Kano and Yobe states.

But what is left to be done by the Government of Nigeria? 

First, considering Nigeria has a population that is largely informal sector, there is need to prioritize coverage for the poorest of the poor and vulnerable population.

Experts from the WISH program say “there is a need to take primary healthcare to the remotest community, just the way beverage companies have been able to get their products to these places”

Second, improving access to family planning services has become imperative and the best investment for the Government of Nigeria at this moment if UHC is ever going to be attained.

There is also no better time than now, for Nigeria to leverage technology for healthcare delivery. Telemedicine can link urban centers to rural communities. This is relevant in view of the massive migration of health workers to “greener pastures.”

Increased accountability is important to ensure commitments are followed through and minimize corruption. Maybe its high time we operate result-based budgeting to underscore the need for efficiency.

10years away from the target date, Nigeria has a decade of opportunities to accelerate the journey towards UHC!

What is left to be done is to subsidize the cost of contributory health care scheme registration to capture a large proportion of the population living in extreme poverty that are unable to pay premiums and reduce the rate of high dropout rate from contributory health schemes across the country.

Primary healthcare service delivery also requires adequate funding to meet with standard requirements.

Therefore, to achieve UHC by 2030, it will be important for state governments to mobilize and raise sufficient revenue to finance health systems while improving the efficiency of revenue generation and utilization.

States with low per capita income and Gross domestic product (GDP) should identify and provide coverage for the poorest of the poor to reduce the proportion of the population that are uninsured in rural areas.

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